Scar Treatment Options: What Actually Helps (and When)

Scar types (quick map)

• Hypertrophic: raised, within the original wound.
• Keloid-prone: can extend beyond the wound edges; needs prevention-minded plans.
• Atrophic/depressed: common after acne; tethered by bands or volume loss.
• Contracture: tightens across joints or high-motion areas.

Early care (weeks 0–12)

• Silicone gel or sheeting: helps flatten and soften while a scar is active.
• Sun protection: daily broad-spectrum SPF 30+ to reduce darkening.
• Support/taping: off-load tension along the incision in high-motion zones.
• Massage: gentle, only as directed after the incision is closed.

Raised or red scars (hypertrophic/keloid-prone)

• Injections: dilute steroid (e.g., triamcinolone) and, in select cases, 5-FU—often as a series.
• Lasers for redness: pulsed-dye or similar vascular lasers can reduce color and thickness.
• Compression & silicone: pressure earrings/sheets for earlobes; silicone for many sites.
• Excision + prevention: when removing a keloid, plan for adjuvants (e.g., steroid series; your surgeon will discuss options).

People vary in scar biology. We tailor settings and sequences—especially for darker skin tones where pigment shifts are a concern.

Depressed/acne scars

• Subcision: releases tethers under rolling scars.
• Microneedling / RF microneedling: stimulates collagen with minimal downtime.
• Fractional lasers: ablative (CO₂/Er:YAG) or non-ablative, chosen to match skin type and goals.
• Targeted chemical reconstruction (TCA CROSS): for ice-pick scars.
• Fillers/fat: to replace volume where needed.

Wide or misoriented scars

Surgical scar revision can realign the scar with natural lines and reduce tension (sometimes with Z-plasty or geometric techniques). Best outcomes pair surgery with silicone, sun protection, and—if indicated—adjunct laser for color/texture.

Surface/texture & color

• Resurfacing: fractional CO₂ or Er:YAG to smooth and blend borders.
• Vascular lasers: to fade redness in fresh scars.
• Camouflage: medical tattooing for pale scars when texture is good but color differs.

When to consider revision

Scars evolve for 6–12 months. Non-surgical options often start earlier; most surgical revisions are planned after the scar matures—unless function is limited or anatomy requires earlier action.

FAQ

Can I prevent a keloid?

No method guarantees prevention. If you’re keloid-prone, early silicone, careful follow-up, and prevention-minded plans after any procedure help.

Are lasers safe for darker skin tones?

Yes, with appropriate devices, settings, and aftercare. Your plan accounts for pigment risk and selects technologies accordingly.

How soon after surgery can I treat a scar?

Silicone and sun protection begin early once the incision is sealed. Injections or lasers are timed to biology; surgical revision is usually delayed until maturation unless there’s a functional reason.